Blame it on Rio

Like so many things, the call came too late. On February 27, my friend Steve read an article in the Guardian reporting the huge epidemic of dengue fever that was sweeping the city of Rio De Janeiro, sending 10% of industrial workers to the hospitals, inspiring a daily newspaper column listing the city's latest celebrity sufferers, and affecting almost half a million people. Steve knew that I was heading for Rio with my wife and 17-month-old son for a three-week stretch. Should we cancel?

I had left the day before he phoned.

Of the myriad dangers regularly attributed to Rio - muggings on Copacabana beach, Colombian-style kidnappings, corrupt police planting drugs on tourists - catching a mosquito-borne tropical disease I was only vaguely aware of was the least of my worries. But upon arriving, it was clear that there was a real fear of dengue in the city. Groups of health workers in black uniforms were knocking on every door, ensuring that any stagnant water, the perfect breeding ground for the aedes aegypti mosquitoes which carry dengue, was removed from all homes. The city had even set a date for dengue D-day: total warfare on the virus, with the aim of pretty much wiping it out for good. That was, I've since worked out, the very day I caught the damned thing.

Nicknamed breakbone fever for the severe joint pains it causes, the virus, which is carried by mosquitoes that tend to strike in the daytime, reduces the sufferer to a 10-day stretch of nausea, severe headaches and constipation, followed by diarrhoea, a burning fever and a florid rash across the body. Unlike malaria, dengue is self-limiting - once the fever kills it off it's out of your system for good - but there is no prevention and no cure, and the body does not build up antibodies to protect itself from potential future attacks.

There are four strains, and if you catch it a second time, there is the danger of developing haemorrhagic dengue. This effectively destroys the platelets that cause blood to clot, meaning that the sufferer can bleed to death. There have been 16 reported deaths from this strain in Rio since the beginning of the year.

It's a virus that follows strange patterns. Unlike malaria, risk is greatest in urban centres: despite the far greater density of mosquitoes in tropical areas of Brazil such as the Amazon and the Pantanal wetlands, it is Rio that is hurting. Although dengue was first identified in areas of Asia and Africa back in 1779, it has only intensified to pandemic levels in the past 15 years. Since then there have been epidemics in India, Sri Lanka and east Africa, and it is currently epidemic in South-East Asia and Venezuela as well as in Rio.

My own initiation into the dengue experience began, inauspiciously, on the plane journey back home. My wife and son had caught an earlier flight and I was looking forward, somewhat selfishly, to a nice quiet night's travelling. I had thought nothing of the intense headaches I had experienced while surfing the day before, putting it down to dehydration and too much time in the unforgiving Rio noonday sun. But an hour or so into the flight, the headache came back, this time accompanied by the most intense bone pain I have ever experienced - it felt like my knees had just been cracked in half. I'm tall, and long plane journeys always involve an element of cramp, but this was far more excruciating than the usual stiffness and dull aches. No amount of walking up and down the aisle did any good, and a couple of painkillers from the cabin crew merely took the edge off.

By the time we landed in Paris for a transfer, I was in a cold sweat. Needless to say, I was stopped by customs officials, who must have taken one look at my anaemic, glistening skin and bloodshot eyes and decided that I had swallowed my stash. I explained I was feeling very ill and I had a plane to catch. Could they let me go?

The customs officials, being French and prone to hypochondria, took the mention of ill health very seriously and let me go. I had just enough time to catch my connecting flight; the doctor would have to wait.

The joy of being back at home brought some temporary relief, but it was short-lived, and, as it turned out, merely part of the virus's pattern: after the first attack, the fever abates briefly before going into its second, more virulent stage. The following morning, I couldn't move or open my eyes. It felt like someone had been giving me a going-over with a mallet during the night. I assumed it was malaria. A taxi ride to the A&E at UCH brought me swiftly to the department of tropical diseases, where a wide-eyed doctor poked my skin, shone lights into my eyes and even whacked my knees with a rubber hammer, before concluding, with more satisfaction than I felt entirely comfortable with, that I was in the throes of dengue fever.

A bed in the isolation room of the tropical diseases ward followed. By this time I had developed the dengue rash, which is bright red, covers the entire body, and burns like hell. What seemed like a constant barrage of doctors appeared to take particular interest in this.

"Look at that," said one to a colleague and two interested students, as he poked a raised patch of particularly bright red flesh on my chest. "Classic dengue rash. Very good example - look at the way the skin comes right up. Not good for you of course, Mr Hodgkinson."

This fascination continued for the next few days. Blitzed on painkillers and having to ask for new sheets every hour or so because of the fever that was causing me to sweat like a vindaloo-addicted tennis player, I was glad for the special treatment. And developing dengue in England rather than Brazil was the right thing to do - in London I was an unusual case, and therefore privy to the best that the NHS had to offer.

After a couple of days, I was onto the shared ward, along with an African man with malaria, an Englishman with a skin virus that had turned one of his big toes into a gnarled claw, and a young Afghan refugee whose body was covered in torture marks. It made me realise that in the great scheme of things, as long as I don't catch dengue a second time and finish up dying a horrible bloody death after being drained of my vital fluids and ending up as a wringed-out sack of flesh, I had got off lightly. If my wife, who is pregnant, or my son, whose immune system is barely developed, had caught the virus, it could have been serious.

After a week, I was out of the hospital and back home. The rash had left red marks across my arms and legs, but the heat and itching had gone down and I was no longer soaking the bed with sweat. I just didn't have any energy. I was also half a stone lighter. It took about 10 days of fatigue and vague melancholy before I was back to normal.

Now the current fear is that dengue is going to spread into Europe, but given its predilection for tropical climates, that seems unlikely for the time being at least. But I do know one thing: next year, we're going to Bognor.